Sir, - My perspective on last November's nurses' dispute was from afar. I was working in Canadian hospitals on six months' leave from my permanent post here. There, the term "Irish nurse" was a brand name for intelligence, commitment and practicality. This praise was not empty and during my time there I was repeatedly requested to help recruit Irish nurses to various Canadian posts. In the evenings I was able to catch up with developments in the nurses' dispute at home in Ireland. One could only be concerned about the way the matter was handled. This is not a partisan criticism, as our public representatives seemed only to be reflecting the values, or lack of them, of our present Irish society.
On returning home one sees the sea change evident in Irish nursing. Nurses, often the very ones that you would like to look after your own family or to work closely with as colleagues, are leaving the profession in large numbers. Many seek posts in a variety of areas such as risk management or pharmaceutical representatives - anything that will take them away from what they see as a very difficult clinical work environment.
It is important to have a historical perspective on the issue. Some people may not be aware that in the 1850s Florence Nightingale came to Ireland to learn from expert nursing techniques developed here by the Sisters of Charity and Mercy, in association with the great Irish physicians of that era. That reputation has been enhanced in the generations since by the profession attracting girls who have the academic qualifications to do any other career they wished. This is the great tradition, built up over so many years, that is in danger of being rapidly demolished.
Rather than blaming any particular Ministers, we should realise that they are merely reflecting the values of the Tiger society. A society in which materialism, litigation and bullying dominate can indeed demolish traditions based on different values. From my own recent North American experience I would plead that our public at least be aware of how close our health care system is heading towards the system there. In that system nurses and doctors spend much of their time constructing legally reproducible defences against envisaged future litigation. They do this through tests and documentation. In such a setting empathy and individualisation of care are easily lost.
If Ireland continues to use North America as its ideal in all aspects of living, many things that we take for granted here will soon be gone. These will include home visits by general practitioners as well as clinical staff caring first and documenting second.
Another notable victory for the Tiger seems imminent. Junior doctors often cannot afford to live anywhere near their places of work. NCHDs working all those hours and on six-month contracts will, if anything, be easier to outmanoeuvre than were the nurses. Whatever reservations the public may have about other health service personnel, they should accept that junior doctors, along with the nurses, represent one of the great remaining resources of idealism and skill in our society.
So please understand our junior medical colleagues in their still unresolved dispute. Please continue to support them in the weeks ahead, even if by chance some of their spokespersons become a little too strident. An understanding of their issue might even allow a full reopening of the nursing issue before it is too late. - Yours, etc.,
David Clinch, Physician, Regional Hospital, Dooradoyle, Limerick.